March 8, 2019

UAMS Uses Little-Known Procedure to Save New Mom

When 22-year-old Christina Gillihan left Searcy in an ambulance bound for UAMS on July 28, she and members of her family were hoping for a miracle.

In the days and weeks after her daughter Kyra’s birth July 2 at a local hospital, Christina developed a blood clot in a main artery of her lung, then a massive hemorrhage in her uterus.

After going through 27 units of blood over a number of days, her bleeding still was out of control, her blood pressure critically low (90/50) her heart rate extremely high (130) – she was dying. Before her ordeal ended, Christina received 37 units of blood, about three times the amount in her body.

She wiped back tears as she recalled her near-death experience.

“I could tell by the way I felt that I was going to die,” she said. “It was hard because the last time I saw Kyra before I came to UAMS I was scared that that was going to be the last time I got to see her.”

Christina arrived at UAMS at midnight and was taken immediately to the angiography suite where her blood vessels were injected with dye to help X-rays identify the location of the hemorrhage. Doctors who saw it said it was among the worst uterine hemorrhages they had ever seen. An OB/GYN physician consulted with Dr. Ruizong Li, an interventional radiologist. A hysterectomy – the complete removal of the uterus – was one option, but the decision was made for Dr. Li to provide a less radical, less invasive approach: a uterine embolization.

A uterine embolization involves threading a catheter from the femoral artery in the groin to the uterine artery, where a series of tiny, sponge-like particles are released, explained Dr. Michael Beheshti, chief of the Division of Interventional Radiology at UAMS.

The particles stop the blood flow. For Christina, the procedure took about 45 minutes. She began to feel better almost immediately, and she was comforted by the sound of a nurse calling out her improving vital signs.

“Literally at the conclusion of the procedure her blood pressure was stable, her pulse rate stabilized, and she was able to go home a few days later,” Dr. Beheshti said.

Christina’s mother, Michelle Spence, of Melbourne, said she will never forget the treatment her daughter received at UAMS.

“The doctors and nurses were right on the ball,” she said. “I can never say in words what UAMS has given back to me.”

Dr. Beheshti said the uterine embolization is a straight-forward procedure, but uterine hemorrhages are uncommon enough that many doctors aren’t aware of the treatment options beyond a traditional hysterectomy. UAMS, for example, sees only a few uterine hemorrhages each year, he said.

“Too often, patients like Christina end up in an operating room and have a hysterectomy, which prevents a woman from ever having another baby,” Dr. Beheshti said, adding that an embolization preserves a woman’s ability to have children in the future.

Christina has been advised by doctors not to have more children, given the complications she experienced this summer. But she says she’s just grateful for the opportunity to be Kyra’s mother.

“I’m thankful for the doctors at UAMS,” she said. “They fixed me up and made it to where I could be with Kyra now.”